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When narcissism is pathological
Narcissistic people are considered to be in love and self-admiring. It is usually used to characterize a person who is strongly related to himself and gives less attention to other people. However, this characteristic must be differentiated from the narcissistic personality disorder. When does narcissism become a disease?
No compassion, fear of criticism: people with narcissistic personality disorder make themselves big and others small. Experts explain what characterizes the disease and where therapies begin.
Narcissists crave attention
Selfish, conceited, in love. That would be how most would describe narcissists. Such people literally crave attention and admiration. They are often ambitious too. In fact, it is not uncommon for them to hold a leadership position - and to do outstanding things. And they are very confident of themselves. Such a personality style is not necessarily pathological.
One in 100 people develop a narcissistic personality disorder
"To a certain extent, narcissism is just another term for a healthy pursuit of self-worth," says Professor Claas-Hinrich Lammers, a psychiatrist and psychotherapist from Hamburg. A narcissistic personality disorder is said to exist if narcissism leads to suffering for the person concerned and their surroundings. Lammers estimates that about one percent of the population has a narcissistic personality disorder.
Those affected have an exaggerated, but at the same time unstable self-esteem. They try to compensate for this by exaggerating and distorting themselves. They tend to overestimate their competencies and achievements. "They increase their self-esteem by having an exaggerated claim," says Lammers.
People with this disorder put themselves above others. Specifically, they try to dominate and control others and to keep their achievements and achievements low or devalue them. "Such behavior inevitably leads to conflict," says Prof. Sabine Herpertz, director of the Clinic for General Psychiatry at Heidelberg University Hospital.
Typical reactions from narcissistic personalities
They show little sympathy and interest in others. If their wishes are not fulfilled, criticism hails. If failures occur, they react with anger, aggression or pejorative statements. "Those affected only have interest in others if they contribute to achieving their goals or if they meet with admiration from others," explains Claas-Hinrich Lammers.
The dilemma of those affected
This leads to a dilemma, according to Lammers: As little as people with narcissistic personality disorder are interested in other people, they are so dependent on their attention and admiration in order to stabilize their self-esteem.
This creates a sense of suffering: first of all from tensions and conflicts with others. And secondly, from the widening gap between reality on the one hand and claims and self-idealization on the other. If those affected are put in their place, they can face existential crises.
Sufferers are often hardly aware of illness
"A big problem is that sufferers often have very little awareness of the disease," says Sabine Herpertz, who sits on the board of the DGPPN (German Society for Psychiatry and Psychotherapy, Psychosomatics and Neurology). Anyone who suffers from a narcissistic personality disorder often only goes to psychotherapy for complications such as depression, eating disorders or an addiction.
The challenges in therapy
The start of therapy can be difficult. "Therapists often need a lot of time to get to the patient at all," says Claas-Hinrich Lammers. Morbid narcissists deal with them in the same way as with other people around them: they want to demonstrate their superiority by devaluing their counterparts.
Therefore, the therapist must first of all convince those affected to open up and build trust. In addition: "Critical self-reflection is often difficult for those affected," says Sabine Herpertz. They are usually unaware of how bad their behavior and appearance are for others.
Learn new behavior strategies
But it is not just a matter of helping those affected to learn to empathize with others. They should also get new behavioral strategies to help them get on better with others. Those who set themselves too high demands are shown achievable goals.
Psychiatrist Claas-Hinrich Lammers gives the example of a man who works more than necessary and regularly works overtime. "With the therapy it turned out that the man worked excessively because there was nothing else in his life that really interested him." In the case, it was not least about helping the patient to find meaningful alternatives to work - such as a nice hobby.
Many are looking for security
In general, according to the expert, the therapy focuses on what is actually missing. Self-idealization and the devaluation of other people are often "just a substitute satisfaction". Many simply have the need for belonging and security.
Here it is important to show those affected individual solutions. "In many cases, it makes sense to involve relatives in the therapy," says Sabine Herpertz. In the course of treatment, relatives would have to learn to formulate their own interests, for example, without devaluing people with narcissistic personality disorders.
Is the disorder curable?
Claas-Hinrich Lammers says: "You cannot fundamentally change a person." Rather, therapy is about illuminating and modifying extreme behaviors and ways of thinking. "This improves the patient's quality of life and reduces suffering," says Lammers. Also for its environment. (vb; source: Sabine Meuter, dpa)
Further information can be found in the article: Narcissism: Narcissistic Personality Disorder (NPS) - causes, symptoms and therapy.